## Traumatic brain injury cases in Hawaii Traumatic brain injuries (TBIs) range from mild concussions to severe cases requiring lifetime care. Hawaii TBI cases get a 2 years statute of limitations. ## Common causes - **Motor vehicle accidents** — leading cause of TBI - **Falls** — especially in older adults and young children - **Sports / recreation** — concussions, repeated impacts - **Assaults / violence** — including gunshot wounds - **Workplace incidents** — falling objects, machinery, falls - **Medical malpractice** — anesthesia errors, surgical errors, missed strokes, birth injuries - **Defective products** — bicycle helmets, vehicle airbags, sports equipment - **Military / blast injuries** ## Three severity levels **Mild TBI / concussion:** - Brief loss of consciousness (less than 30 minutes) - Glasgow Coma Scale 13-15 - Often called "concussion" - Symptoms can persist for months or years (post-concussive syndrome) - Often missed by emergency rooms or initial doctors **Moderate TBI:** - Loss of consciousness 30 minutes to 24 hours - Glasgow Coma Scale 9-12 - Significant cognitive / behavioral changes - Often requires extensive rehabilitation **Severe TBI:** - Loss of consciousness more than 24 hours - Glasgow Coma Scale 3-8 - Often results in lifelong disability - Lifetime care needs - Highest mortality and disability rates ## Common symptoms **Cognitive:** - Memory problems (short-term especially) - Concentration / attention difficulties - Slowed processing speed - Executive function deficits - Word-finding difficulties - Problem-solving deficits **Physical:** - Headaches (chronic) - Dizziness / balance problems - Fatigue - Sleep disturbances - Nausea / sensitivity to light and sound - Vision / hearing changes - Seizures **Emotional / behavioral:** - Mood swings - Depression / anxiety - Personality changes - Irritability / anger - Impulsivity - Decreased social filter **Long-term:** - Increased risk of dementia / Alzheimer's - Chronic Traumatic Encephalopathy (CTE) from repeated injuries - Higher suicide rates - Substance abuse vulnerability ## The "invisible injury" problem TBIs often don't show on standard MRIs / CT scans — particularly mild TBI / concussions: - Diffuse axonal injury microscopic damage - Functional changes without structural damage - Symptoms develop or worsen over time - Patients look fine to lay observers - Insurance companies / juries may doubt the injury Specialized testing required: - **DTI (diffusion tensor imaging)** - **PET scan** - **fMRI** - **Neuropsychological testing** (gold standard for cognitive deficits) - **Vestibular testing** - **Day-in-the-life videos** ## Damages typically pursued **Economic:** - Past and future medical care - Cognitive and physical rehabilitation - Vocational rehab - Lost wages - Lost earning capacity (often substantial) - Attendant care / supervision - Special education / tutoring - Modified housing / vehicle **Non-economic:** - Pain and suffering - Emotional distress - Loss of enjoyment of life - Personality / cognitive changes - Loss of consortium for family members ## Critical experts - **Neurologist** — diagnosis and prognosis - **Neuropsychologist** — cognitive testing, baseline establishment - **Neurosurgeon** — for surgical or post-surgical cases - **Physiatrist (PM&R)** — rehabilitation - **Vocational expert** — earning capacity - **Life care planner** — projecting lifetime needs - **Economist** — present value of future losses - **Accident reconstructionist** — for crash / fall cases - **Day-in-the-life videographer** — capturing daily struggles ## Time-critical issues - **Early diagnosis** — symptoms develop slowly; document promptly - **Baseline neuropsychological testing** — within first 90 days when possible - **Pre-injury records** — school records, employment evaluations, prior medical (essential for proving change) - **Witness statements** — about pre-injury behavior / personality - **Symptoms diary** — daily journal of cognitive / physical / emotional issues ## What you should do If you or a loved one has suffered a brain injury in Hawaii: get specialized medical evaluation (neurologist, neuropsychologist), document everything contemporaneously, do NOT post about it on social media, and contact a personal-injury attorney with TBI experience IMMEDIATELY. Most Hawaii TBI attorneys offer free consultations and work on contingency. The investment in expert witnesses is substantial; experienced firms front the costs. --- *This guide is general information about Hawaii law as of early 2026 and is not legal advice. TBI cases involve complex medical evidence and long-term planning. Talk to a licensed Hawaii catastrophic-injury attorney about your specific case.*